Children whose hearts stop while they are in the hospital need fast, well-coordinated resuscitation to give them the best chance of surviving their cardiac arrest. But because pediatric cardiac arrests are (fortunately) rare, pediatric physicians, nurses and other caregivers have few opportunities to experience a real response to this life-threatening emergency. And rehearsing what to do in educational settings outside the hospital may not give responders the chance to practice for unexpected problems that can arise in real life.
To solve this problem, a team at Lucile Packard Children's Hospital Stanford implemented a new training approach. Lynda Knight, RN, MSN, the hospital's pediatric resuscitation program educator, wanted to make sure that every person responding to emergency "codes" broadcast through the hospital when a patient's heart stops - from attending physicians to security guards - had regular opportunities to practice working together. Knight and Deborah Franzon, MD, led a group that staged mock "codes" to simulate cardiac arrests in many locations throughout the hospital.
After the new training was implemented, the hospital's survival rate for cardiac arrest patients jumped from 40 percent (a figure similar to the national average for children's hospitals) to 60 percent. The findings were published this week in Critical Care Medicine.
From our press release about the study:
One key goal of the training package was for one person to quickly assume the role of the code team leader, and for others to take on specific, pre-defined roles in the team's response. The roles were based on American Heart Association guidelines about best practices for resuscitation.
"It's sort of like an orchestra," Franzon said. "Everyone has a really important part to play." For instance, one physician or nurse stood at the code cart, distributing equipment. A social worker comforted the patient's parents. Security guards directed unnecessary foot traffic away from the area. A nursing supervisor made sure all essential roles were filled quickly.
"With this training in place, responding to codes becomes muscle memory for the whole team," Knight said. "That's what's going to save lives."